World Traveler™

570.226.4571 amskier@amskier.com

Mary Helen and Suzanne, AMSkier Insurance World Traveler™ Agents
We encourage you to contact MaryHelen and Suzanne, our World Traveler ™ Coordinators and Experts, to be helpful anytime - call - 570-226-4571 or email
worldtraveler@amskier.com.

If you wish to print out and mail the form, click here.

AMSkier Insurance World Traveler Program™

World Traveler™ is a very special international travel insurance program developed by AMSkier for adults, students, and business groups.
Name:
A value is required.
Contact:

A value is required.
Address:
A value is required.
E-mail:

A value is required.
City:
A value is required.
Phone:

A value is required.
State:
Zip:
A value is required.
Date of Departure: A value is required.
Date of Return: A value is required.
Type of Organization:
Years in Business:
A value is required.

General Information

Purpose of Foreign Travel:
A value is required.
List of Countries of Travel:
Country 1:

A value is required.
    
Country 2:
   
Country 3:
   
Country 4:
   
Have you had any losses in the past 3 years (outside US):
Please discribe:
Do you want Sexual Abuse Act coverage?

Does your organization have a plan for reporting potential sex abuse incidents?

Does your organization conduct background checks on employees and volunteers?

Trip Travel Exposure for Employees, Students, Chaperones and Others Traveling

# of Participants:
A value is required.
# of Employees:
A value is required.
# of Chaperones:
A value is required.
# of Other:
A value is required.
Identify the activities involved in these trips during travel outside the U.S.? Check all that apply.
Conference
Convention
Cultural/Sightseeing Field Trip
Campus Visits
Seminar
Study Abroad
Exchange Program
Athletic Competition

Authorized Person:

A value is required.
Title:

A value is required.
Date:

A value is required.
- I agree that I am authorized to purchase this insurance on behalf of my organization and all the above information is correct to the best of my knowledge. You must agree!
Security Code from above:

A value is required.
 
AMSkier’s World Traveler™, an ACE International Advantage Express® product, a very special
international travel insurance program for adults, students, and business groups.


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